5TH Street 1808 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

5TH STREET 1808 LLC

Practice address

1808 5TH St
Sanger, CA 93657-2313

Phone

(650) 776-2280

NPI assigned

Nov 18, 2024

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elsa Nguyen

Title

Licensee

Phone

(650) 776-2280

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1831914639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 5TH ST",
            "city": "SANGER",
            "state": "CA",
            "postal_code": "936572313",
            "telephone_number": "650-776-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 5TH ST",
            "city": "SANGER",
            "state": "CA",
            "postal_code": "936572313",
            "telephone_number": "650-776-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH STREET 1808 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "ELSA",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "650-776-2280"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Acevedo, OPTICIAN
• Adventist Health Physicians Network
• Alma Aguirre
• Jacob Taiwo Akindele, ARDCS
• Alleluia (Pearl Gates Home)

• Assisted Living Facility in Sanger, CA
• Providers in Sanger, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.